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#159183 - 12/19/12 08:25 PM please advise
bassaniobroke Offline

Registered: 12/19/12
Posts: 1
Loc: Pakistan
My father age 90 has been diagnosed with squamous cell carcinoma of buccal mucosa , ie cheek. there is ulcer inside and tumor outside which has increased to the size of tomato after biopsy (previously it was size of large grape) biopsy report says" infiltrating, moderately differentiated, keratinizing, squamous cell carcinoma"
1 ent surgeon: ready to do 6 hr surgery but can not gurantee recovery from anesthesia and healing.
2: ent surgeon: get done limited cleaning but not complete treatment, which means not to track lymph nodes
3: ent surgeon: do nothing as whole process is very risky and there may be chance of going into coma due to age and angina and heart problems, he even said limited cleaning is also very much risky.
4: hospice: said in his experience such surgery bring no good result at this age.
please advise what I should do.

#159186 - 12/19/12 09:58 PM Re: please advise [Re: bassaniobroke]
davidcpa Offline
Administrator, Senior Patient Advocate
Patient Advocate (old timer, 2000 posts)

Registered: 09/28/06
Posts: 8311
Loc: Gulfport, Florida
So sorry that you are put in this decision making process but unfortunately we can't advise you. This is really between you, your Dad and his doctors. Whatever the decision we will be here to help in any way that we can.

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.

#159188 - 12/19/12 10:48 PM Re: please advise [Re: bassaniobroke]
ChristineB Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Registered: 06/23/07
Posts: 9427
Loc: PA
Welcome to OCF!

I am very sorry your father is going thru this! Its such a shame the cancer is so advanced it is difficult to treat. If you have not done so already, seek out the most experienced doctor available at a large cancer center.

Unfortunately I can not help you to make this difficult decision. Its not going to be easy no matter which route you decide. Best wishes with everything!

Edited by ChristineB (12/20/12 03:53 AM)
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07, no caregiver
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo extended hospital stay, ICU & burn unit
PICC line w/ IV antibiotics 8 mo
10/4/10, 2/14/11 reconst surg
OC 3 times in 3 years
very happy to be alive smile

#159247 - 12/20/12 08:54 PM Re: please advise [Re: bassaniobroke]
Cheryld Offline
"OCF Canuck"
Patient Advocate (old timer, 2000 posts)

Registered: 12/22/10
Posts: 5260
Loc: Toronto canada
The decision is up to you of course - the surgery may be trying depending on his health if he is willing and able to do it -
Then it's actually not too bad of a recovery assuming the surgery goes okay and he doesn't have problems healing . (Diabetes etc.)
Follow up treatment for this is normally rads if there's nodal involvement however if your surgeon does the surgery (and removes the nodes - and feels he's gotten it all) then that may be all he needs. Is your dad a young 90 in decent health? Or is he more complicated ? This and his input should be what is used to determine what should be done - for what it's worth the surgery isn't that bad it looks dad worse than it feels. Take care
Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan

#159255 - 12/20/12 10:28 PM Re: please advise [Re: Cheryld]
tamvonk Offline
"OCF Kiwi Down Under"
"Above & Beyond" Member (500+ posts)

Registered: 03/11/11
Posts: 994
Loc: New Zealand
This is a very difficult situation for you to be in.
If this was my 90 year old Dad I would not be seeking all the bells and whistles of treatment. It is difficult enough for a 60 year old. Let alone a man of 90 who also has cardiac complications.. I would maybe look to have the tumour debulked as this would contribute to comfort and then talk to Hospice.
Be guided by your gut feelings and what your Father would like to do. Also taking into consideration the medical teams advice.
In my experience in the NZ hospital system only palliative care would be offered here. It is all about the benefit and quality of life your Father is likely to have.
Thinking of you,
Caregiver/advocate to Husband Kris age 59@ diagnosis
DX Dec '10 SCC BOT T4aN2bM0 HPV+ve.Cisplatin x3 35 IMRT.
PET 6/11 clear.
R) level 2-4 neck dissection 8/1/11 to remove residual node - necrotic with NED
Feb '12 Ca back.. 3/8/12 total glossectomy/laryngectomy/bilat neck dissection/partial pharyngectomy etc. clear margins. All nodes negative for disease. PEG in.
March 2017 - 5 years disease free. Woohoo!

#159265 - 12/21/12 02:09 PM Re: please advise [Re: bassaniobroke]
Charm2017 Offline
Patient Advocate (old timer, 2000 posts)

Registered: 03/03/08
Posts: 3082
Loc: Alexandria VA
What does your father want to do? At 90, I'd check into a hospice , knowing what I know now about how the treatment changes your quality of life especially if my surgeon said I might not survive the surgery etc. I am 65 and have been fighting this for 5 years, and at my age, it is very doable. But 25 years from now would be a different story.
So sorry that you have to deal with this. Don't worry though, any decision you make will be made out of love and in the end that is all that matters.

Edited by ChristineB (12/21/12 06:25 PM)
Edit Reason: corrected years
65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13


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